Certified Nursing Assistant Class Information
This program is designed to prepare students* to provide basic health care in hospitals and nursing homes. The program will provide training experience and educational opportunities that will benefit you and your community.
*16 & 17 year olds must show proof of high school withdrawal to enroll
The class consists of two components: 1) 99 hours of classroom theory 2) 40 hours of clinical experience 100 % attendance is required for state certification requirements
Successful completion of this course will lead to certification by the Illinois Dept. of Public Health
ADMISSION PROCEDURE:
STEP 1: An application package must be completed with all supporting materials attached (2-Step Tuberculosis,
I want to be a CNA questionnaire, Physical Verification Form) AND it must be turned in by the deadline stated in the application. Incomplete application packages will not be considered for enrollment. The CNA program is extremely competitive and space is limited.
STEP 2: A limited number of applicants will be invited to attend an orientation where they will receive additional information about completing the process to register for classes. If you are invited to an orientation but do not attend your application will be considered void and you must complete the process again to be considered. Again, all of the application must be filled out with required attachments or the application is void.
STEP 3: Each applicant must pass assessment at the pre-determined level. - Eighth grade reading level
- 80% minimum score on math assessment (Remedial tutoring may be required) (Applicant notified of results)
STEP 4: Schedule appointment to do a live scan fingerprint check. The cost is $30.50 payable by check or money order (no cash) at the appointment. The number to call is – 1(800) 377-2080. The scan will be given at DACC/Prairie Hall – Room 113 Background checks must come back clear.
Successful completion of all steps will place students into the first available class. STUDENT COSTS:
Tuition is paid for students residing in college district #507. Other costs include: - 2-Step TB test @ Verml. Co. Health Dept. $48 (cash/check or Illinois medical card) - Course/Lab Fee $65.00 (Must be paid by 1st day of class) - Uniform, shoes (white), watch, Cost varies (Available in DACC Bookstore) gait (safety) belt
-Textbook / Workbook $84.50 DACC Bookstore
Please be sure to get your photo ID before you rent your book!! COMPETENCY EXAM: $65.00 fee (Money Order only to SIUC)
The Nurse Aide Competency Evaluation Program is a measure of nurse aide related knowledge, skills and
abilities. The purpose is to see if individuals are able to understand and safely perform the job of nurse aide. The test is taken upon successful completion of the program.
CLASS MEETS:
DACC / Prairie Hall / Room 107-108 Instructors Office - Prairie Hall / Room 102/109 Or) DACC Higher Education Center Hoopeston 847 E. Orange Street in Hoopeston
Please check
one
OFFICE STAFF ONLY: Received by: ____________ Date:__________________
CERTIFIED NURSING ASSISTANT (CNA)
Application Packet
This program is designed to prepare students to provide basic health
care in hospitals and nursing homes. The program will provide
training experience and educational opportunities that will benefit
you and your community. To enroll in the program you must
complete this application packet in its entirety.
STEP 1: An application package must be completed with all supporting materials
attached. Incomplete application packages will not be considered for enrollment. The
CNA program is extremely competitive and space is limited.
STEP 2: A limited number of applicants will be invited to attend an orientation where
they will receive additional information about completing the process to register for
classes.
If you are invited to an orientation but do not attend your application will be considered void and you must complete the process again to be considered. Again, all of the application must be filled out with required attachments or the application is void._____________________
_____________________ _____
FALL
Last Name First Name ______ SPRING
______ SUMMER _______________________________________________________________
Street Address City State Zip code ( _____ ) ________ - _____________
Area Code Phone Number
CHECKLIST
_____ 2-Step Tuberculosis (TB) test (or verification of one within last 6 months) _____ ‘I want to be a CNA' questionnaire
2-STEP TUBERCULOSIS TEST **
Must be completed and turned in as part of the CNA application package. The TB test cam be administered through a personal physician or the Vermilion County Health Dept. ____________________ ________________________ ______/ _____/______ First Name Last Name Date of Birth
The First TB Test is given and read by the same health care facility of your choice within 48-72 hours. The Second TB Test is to be completed with 7 to 21 days from the first TB test. It is given and read by the same health care facility of your choice within 48-72 hours.
Have you ever had a positive TB test? Yes _____ No _____
TB test results will only be kept on file and counted toward meeting this requirement one year from the date first given in TB step 1 below:
TB step 1:
Date Given: _______ Time Given ______ Lot No. ________ R. /L. Forearm Nurse: _____________ Date Read: ______________ Time Read _______________Results ________ Nurse: _____________ TB step 2:
Date Given: _______ Time Given ______ Lot No. ________ R. /L. Forearm Nurse: _____________ Date Read: ______________ Time Read _______________Results _______ Nurse: ______________
TB Update:
Date Given: _______ Time Given ______ Lot No. ________ R. /L. Forearm Nurse: _____________ Date Read: ______________ Time Read _______________Results _______ Nurse: ______________
** If you have had a TB test within the last 6 months you may submit those results
‘I WANT TO BE A CNA' questionnaire
____________________ ________________________ ______/ _____/______ First Name Last Name Date of Birth
1. Do you have transportation? Yes_____ No_____
2. Tell us about yourself:
3. List five qualities you possess that would make you a good candidate for the CNA
program:
4. Do you know what being a CNA entails? Briefly describe:
‘I WANT TO BE A CNA' questionnaire page 2
6. How do you feel about working with the elderly?
7. How can we know you will be committed to the program?
8. What would you do if you heard or saw an employee physically or verbally
abusing a resident?
9. What are your career goals?
10. The class consists of three components: 15 hours of pre-employment activities; 99
hours of classroom theory; and 40 hours of clinical experience. 100% attendance
is required. What plan do you have in place to ensure you do not miss class?
PHYSICAL VERIFICATION FORM
____________________ ________________________ ______/_____/______ First Name Last Name Date of Birth
Check the appropriate answer. Please answer as honestly as possible. If yes is checked, please provide an explanation in the space provided.
YES NO EXPLANATION Allergies? Pregnant? On Medication? Mental Health Concerns? Hearing Problems? Back Problems? Knee Problems? Recent Surgeries? Lifting Restrictions? Latex Allergy?
If you are pregnant, have any back problems/lifting restrictions, or a medical condition that is being monitored by a physician, a note will be needed from the physician that states you are in good health, free of any communicable disease and has no known deficits that would interfere with the ability to participate in the lab/clinical setting or in the completion of the required three components of the CNA program, which includes 15 hours of pre-employment activities, 99 hours of classroom theory and 40 hours of clinical experience.
Please list any other conditions that you feel may present a risk for you or that your Instructor should be aware of to protect your well-being and safety:
